Ventilators-by-Lottery: The Least Unjust Form of Allocation in the COVID-19 Pandemic

Abstract

Because of the scarcity of ventilators in ICUs during the coronavirus disease 2019 (COVID-19) pandemic, there are reports that in Italy ventilators were being allocated on the basis of who had the best chance of survival. One Italian medical college recommended that “[i]nformed by the principle of maximizing benefits for the largest number…the allocation criteria need to guarantee that those patients with the highest chance of therapeutic success will retain access to intensive care.”1 In New York, pharmacists “are beginning to sound an alarm” that there is a lack of sedatives, pain killers, and paralytics for those who require intubation and artificial ventilation.